Pregnancy Outcomes among Patients with Sickle Cell Disease at Korle-Bu Teaching Hospital, Accra, Ghana: Retrospective Cohort Study

Abstract

Abstract. Pregnancy in sickle cell disease (SCD) patients is associated with increased risk of maternal and fetal mortality. This study determines pregnancy outcomes among women with SCD delivering at Korle-Bu Teaching Hospital, Accra, Ghana. Nine hundred sixty (960) medical records of pregnant women (131 HbSS, 112 HbSC, and 717 comparison group) from 2007 to 2008 were reviewed. The HbSS women were at increased risk of eclampsia (adjusted odds ratio [AOR] = 10.56, 95% confidence interval [CI] = 3.60-30.96, P 0.001), intrauterine growth restriction (AOR = 4.00, 95% CI = 1.38-11.64, P = 0.011), and placenta previa (AOR = 22.03, 95% CI = 9.87-49.14, P 0.001) compared with the comparison group. The HbSC women had increased risk for intrauterine fetal death (AOR = 3.38, 95% CI = 1.15-9.96, P = 0.027) and decreased risk of delivering low birth weight babies (AOR = 0.21, 95% CI = 0.06-0.73, P = 0.014). Women with SCD in Ghana are at a greater risk of morbidity and mortality in pregnancy compared with women without hemoglobinopathies. Improved maternal and fetal outcomes in Ghanaian women with SCD can be achieved through effective intervention by health care providers with thorough knowledge about predisposing factors toward adverse outcomes.

Fetomaternal outcome in sickle cell hemoglobinopathy in a tertiary care centre of North Kerala, India

“…But, unlike reported earlier, GDM and was comparable with normal population. 15,17 As previously reported, present study showed a 100% incidence of moderate to severe anemia in HbSS antenatal women; while there were studies with anemia as less as 8.4%. 9,22,17 But we found anemia in only 46.88% of HbAS women as against the 95% in earlier reports.…”

“…9,15 Similar to many other studies, we found that obstetric complications like preeclampsia and gestational hypertension were high in women with sickle cell disease with a higher risk in homozygous (HbSS) genotype. [9][10][11][15][16][17][18][19] Eclampsia which is a life threatening complication of preeclampsia was reported to be 10 times high in HbSS women. 17 This study also showed a higher incidence of eclampsia in consistent with an earlier metaanalysis and also reports from other states of India.…”

“…[9][10][11][15][16][17][18][19] Eclampsia which is a life threatening complication of preeclampsia was reported to be 10 times high in HbSS women. 17 This study also showed a higher incidence of eclampsia in consistent with an earlier metaanalysis and also reports from other states of India. 9,11,20 Intrauterine growth restriction was seen in more than onethird of the SCD women and such a higher incidence was shown in literature.…”

“…9,11,20 Intrauterine growth restriction was seen in more than onethird of the SCD women and such a higher incidence was shown in literature. 17,18,21 Chronic maternal anemia and hypertension in pregnancy resulting in reduced placental perfusion is the most likely reason for intrauterine growth restriction. But, unlike reported earlier, GDM and was comparable with normal population.…”

Adverse maternal and perinatal outcomes in pregnant women with sickle cell disease: systematic review and meta-analysis

“…The characteristics of the 21 studies included in the meta-analysis are outlined in Table 2 (HbSS disease [12][13][14][15][16][17][18][19][20][21][22][23] ), Table 3 (HbSC disease 6,17,18,20,23 ), and Table 4 (SCD with genotype not specified). [24][25][26][27][28][29][30][31] All studies were categorized as pregnancy cohort studies.…”